Current and emerging therapies in nonalcoholic fatty liver disease.
The prevalence of obesity and the metabolic syndrome (MS) is on the rise, and subsequently the hepatic manifestation of MS, nonalcoholic fatty liver disease (NAFLD), has become a common entity in clinical practice. Most patients with NAFLD face medical complications related to their underlying MS in other organ systems; however, a small but significant group of patients with the more aggressive form of fatty liver, nonalcoholic steatohepatitis (NASH), are at risk of developing cirrhosis and hepatocellular carcinoma. As patients are generally asymptomatic, often their disease goes unrecognized. This is particularly true for NASH, where liver biopsy is currently required to make the diagnosis. Once diagnosed, no one treatment has been shown to be universally efficacious and those that are of benefit are not without side effects. Effective treatment regimens directed at both decreasing insulin resistance as well as the processes leading to necroinflammation and hepatic fibrosis have been investigated and include lifestyle modification, surgical therapies, and pharmacotherapy. This review focuses on current and potential future therapies for NASH.
Kashi
Maryam R
MR
University of Texas Health Science Center at San Antonio, Texas, USA.
Torres
Dawn M
DM
Harrison
Stephen A
SA
D000818:Animals; D000975:Antioxidants / Q000627:therapeutic use; D050110:Bariatric Surgery; D015992:Body Mass Index; D002186:Cannabinoids / Q000037:antagonists & inhibitors; D002756:Cholagogues and Choleretics / Q000627:therapeutic use; D015897:Comorbidity; D005234:Fatty Liver / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D052216:Glucagon-Like Peptide 1 / Q000031:analogs & derivatives; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007333:Insulin Resistance; D007783:Lactones / Q000627:therapeutic use; D008019:Life Style; D008687:Metformin / Q000627:therapeutic use; D009765:Obesity / Q000188:drug therapy / Q000453:epidemiology; D000077403:Orlistat; D010880:Piperidines / Q000627:therapeutic use; D011720:Pyrazoles / Q000627:therapeutic use; D000077285:Rimonabant; D045162:Thiazolidinediones / Q000627:therapeutic use; D016896:Treatment Outcome; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use; D015431:Weight Loss
D000975:Antioxidants; D002186:Cannabinoids; D002756:Cholagogues and Choleretics; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D007783:Lactones; D010880:Piperidines; D011720:Pyrazoles; D045162:Thiazolidinediones; D014580:Ursodeoxycholic Acid; D052216:Glucagon-Like Peptide 1; D008687:Metformin; D000077403:Orlistat; D000077285:Rimonabant